Enforcement of HIPAA Standard Compliance by ReyeneJohn


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									              Enforcement of HIPAA Standard

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Implementation of Efficiency

The latest version of the Health Insurance Portability and Accountability Act standard electronic claims
and related transactions by January 1st, should be implemented by the covered health care providers
that include covered dentists, but the enforcement grants time till March 31st. With the HIPAA 5010
transaction set of standards specifying an orderly organization of the electronic data interchange
communications content deployed in healthcare, these data evolve over claim status inquiries,
electronic claims, claim attachments, eligibility inquiry and response amongst other specifications.
According to the announcement of delayed enforcement, the Centers for Medicare & Medicaid Services’
Office of E-Health Standards and Services said that covered entities and trading counterparts would be
ready to comply by January 1st. The OESS is also aware that many of the covered entities are still waiting
for the software upgrades that are necessary for compliance.

The ADA advises that all covered dentists should organize their practice management and electronic
claims software vendors to be ready by 5010. If dental billing systems need to upgrade to be able
support version 5010, the dentists should verify the same with the vendor. Dental offices that go
through clearinghouses to transmit claims electronically will be required to upgrade systems and curtail
claims that do not synchronize with the latest information. Version 5010 specifications are not part of
the HIPAA Privacy and Security Rules but have their origins in the HIPAA Transactions and Code Sets
regulations. Clearinghouses that dental offices might use to transmit their claims electronically are also
required to upgrade their systems and should curtail claims that do not include the latest information.
Covered dentists who change submission of claims or who introduce new technology should go through
re-evaluation of HIPAA security procedures and policies and update them accordingly.

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